Safe to Be Themselves

Dr. Fetterman is the Clinical Director of Cleveland Clinic’s Summer Treatment Program (STP) for Kids with ADHD. There are few programs in the world like it. 

Her on-site staff of 45 counselors work with young people who variously show symptoms such as excessive movement and difficulty with focusing and self-control. If that sounds challenging, consider that for seven hours a day, the staff are also tasked with collecting data on various behaviors for each of the 65 kids. 

INSTANTANEOUS AND INTENSE FEEDBACK

First developed at the University at Buffalo in 1980, STP is based upon strong science which shows that the most effective nonmedicative treatment for someone with ADHD is evidence-based behavioral intervention. Or simply put: in-the-moment feedback. 

“We give the kids a level of intense feedback that they don’t get anywhere else,” Dr. Fetterman says. “There’s no way a teacher could give a person feedback every time something happens. And because their behavior is constantly recorded, if a young person is on medication, its efficacy or lack thereof is easily determined.” 

The program was introduced to Cleveland Clinic by Michael Manos, PhD, who was the Clinical Director of STP until 2023. “The summer treatment program is considered the best behavioral intervention there is for ADHD,” Dr. Manos says, “because with it we increase the frequency of nine positive behaviors and decrease the frequency of 13 negative behaviors.” 

Most STPs are designed solely for children, but Cleveland Clinic also offers an STP for adolescents. At all ages, kids at STP are typically experiencing behavioral issues at home, such as tantrums or noncompliance; or perhaps disruptive behavior at school or poor school performance.

CULTIVATING AWARENESS

STP is sports-oriented — participants play basketball, softball and baseball, with timeouts, clear rules and established routines. Positive behaviors earn kids praise and rewards according to a response point system. From the time children arrive at 9 a.m. until they leave at 4:30 p.m., the point system helps the staff evaluate their behavior. For instance, a person who interrupts might lose 20 points, and begin to realize that it might be a good idea to raise their hand next time. 

“I always tell families, even if they come out of the summer and their child is still, say, interrupting a bit, now he or she knows they’re interrupting,” Dr. Fetterman says. “It’s a new awareness that may empower the child to use some of their new skills or ask for help when they need it. So sometimes things aren’t as tangible as just looking at a graph of a person’s behavior.” 

A primary result of an STP summer is awareness — of rules, of what ways of being work best around others, of their physical being. Every day there is a 30-minute lesson about learning about their feelings: how the feelings present in the body, what coping skills they can use and when they should use them. 

In addition, the parents or caregivers participate in a weekly 90-minute discussion to learn how to implement similar strategies at home. “Many of the parents who have participated in the program for several years provide encouragement to families new to the program and/or an ADHD diagnosis,” Dr. Fetterman says. “It’s beautiful to see parents sharing their feelings and perspectives with each other. STP fosters a sort of community among ADHD families. 

“We always get lots of comments from kids and parents who say that STP is a really wonderful place because their kids feel safe to be themselves.” ◼